Provider Support Call 1-25-16 Notes From Call

Agenda  Case Managers and providing Specialized Equipment to participants they serve  LT 104 Completion  ICAP Submission with Plans of Care  Case Management Electronic Monthly Report Form  New Process Flow for EMWS for ECC, CRT, Reconsiderations and Goods and Services  HCBS Transition Plan Update  Reminder of No More Variance Reporting  Self-Directed Providers and Certification Monitoring  Submitting Plans of Care Late  Medicaid Re-Enrollment Update  HCBS Right Restrictions and Restoration Plan in the Plan of Care

TOPICS Case Managers and Providing Specialized Equipment Services to Participants they Serve If a provider is providing case management to a participant, they are not allowed to provider ANY other waiver service to that participant as it is a Conflict of Interest. According to our Conflict Free Case Management Model, per page 5 under Formal Exclusions: “A case management agency may be certified in other waiver services, but shall not provide case management services to any participant they are providing any other waiver to, including self-directed services”. Due to this, specialized equipment services are a waiver service and cannot be given to a participant that is receiving case management from the same provider. LT 104 Completion Once a Case Manager has been selected by an applicant, the LT 104 needs to be completed within 30 Days of the selection. ICAP Submission with Plans of Care Some Plans of Care have been submitted with expired ICAPs. These plans must be submitted with ICAPs that have not expired. EMWS will notify the case manager 90 days prior to the ICAP expiring. This will show up in the taskbar and the case manager will need to complete the ICAP Checklist and request the ICAP. Case Manager Monthly Report update Just a reminder that the Case Management Monthly Electronic Report is still in the testing phase. We are unsure when all of the testing will be complete or when this system will go live. We are hoping to have it fully operational in the next couple of months. We will update you as we move closer to the go live date.

We apologize for any inconvenience. Please continue to submit your Case Management Monthly Form as you always have.

New Process for EMWS for ECC, CRT, Goods and Services and Reconsiderations The Wyoming Department of Health, Behavioral Health Division (Division) has enhanced the Electronic Medicaid Waiver System (EMWS) to allow for electronic submissions of Supplemental Requests. These

2 Provider Support Call 1-25-16 Notes From Call

Supplemental Requests include requests for the Extraordinary Care Committee (ECC), Clinical Review Team (CRT), Goods and Services, and Reconsideration Requests.

On January 5, 2016, Case Managers began using EMWS to submit these Supplemental requests. Case Managers can now upload the required documentation and create a task under the Supplemental Requests tab. This enhancement will allow everyone involved to know where to look for information on a request and the current status of the request, i.e. when it was submitted, when it is scheduled to be reviewed, if additional information is required, and the decision on the request.

All Supplemental Requests must now be submitted in this manner. As the request proceeds through the process, there will be a task created for the next step and this will enable the Division and Case Managers to keep these Supplemental Requests moving and prevent requests from being overlooked in the participant’s document library.

Copies of the process flow charts for each of these requests can be found on the BHD website by clicking on EMWS under the Hot Links section of the webpage. Please remember, these process flows are for reference and may not answer all of your questions about the process.

For specific questions on these Supplemental Requests, please contact your Participant Support Specialist and they will be happy to assist you with this new process. http://www.health.wyo.gov/ddd/waiversystem.html

HCBS Transition Plan Update If you have submitted a HCBS Transition Plan to the Division, the Division is in the process of reviewing, entering and providing feedback to providers. At this time, we are thoroughly reviewing plans to make sure that the feedback provided will be the most useful, helpful, and guiding to providers in this process. This has taken much longer than we expected and appreciate your patience through this process. As the Division receives weekly updates from CMS, we are incorporating these updates into plans. If you have questions about specific milestones submitted or questions of where your plan is in the process, please feel free to contact your Provider Support Specialist. If you have not submitted your HCBS Transition Plan, received your setting survey final report or completed your initial survey, please contact your Provider Support Staff immediately. Variance Reporting and SIS Pilot Due to the budgetary issues for providers and the Division, the Division has decided to prioritize certain projects and eliminate others:  At this time we will be cancelling the implementation of variance reporting across providers.  The pilot to explore the use of the Supports Intensity Scale, or SIS, is also being stopped.

Self-Directed Providers and Certification Monitoring All Self Directed Providers are responsible to making sure all of their certification (example, First Aid/CPR, MAT, ect) are current.

2 Provider Support Call 1-25-16 Notes From Call

Submitting Plans of Care Late If submitting a Plan of Care Late, case managers should enter the reason why the plan is late into the notes section in EMWS.

Medicaid Re-Enrollment Update Xerox will provide us a report weekly (starting Monday) of all providers who have not yet started the re- enrollment process. There are currently about 2700 providers at some stage in the process. On Jan. 29, Xerox will be deactivating all providers who have not yet started re-enrollment. Xerox will NOT be terming any provider who is somewhere in the re-enrollment process. If needing further information, please visit http://wymedicaid.acs-inc.com/aca_reenrollment.html or call 1-800-251-1268.

HCBS Rights Restrictions and Restoration Plan in the Plan of Care If a Plan of Care is needing a Rights Restriction and Restoration Plan, these are due to the Division by February 28, 2016.

Next call is on February 29th, 2016

2